San Antonio Express-News (Sunday)

Aerobic exercise vs. weightlift­ing

Bumble, other dating apps seek to take sting out of inappropri­ate language and activities

- DR. KEITH ROACH To Your Good Health

Q: Can you comment on the benefits of weightlift­ing over aerobic exercise? I know that any exercise is beneficial compared with nothing, but which is better for losing weight long term? Running or jogging can burn calories, but I have read that muscle requires more energy metabolica­lly and therefore the more muscle you build, the more fat you will burn.

A: Researcher­s have debated the relative benefits of aerobic exercise against weightlift­ing exercise for many years, and there remains debate. However, I can give you the general consensus.

First, the distinctio­n is often not absolute. Weightlift­ing burns calories aerobicall­y; however, many serious weightlift­ers take pains to make sure that their aerobic capacity does not limit their ability to lift by resting in between repetition­s. Similarly, many “aerobic” exercises use elements of resistance, so there is considerab­le overlap.

There are benefits to resistance exercise that even high amounts of pure aerobic exercise cannot achieve. Resistance training has a much larger effect on bone health. Empiricall­y, those who do resistance training have lower rates of both falls and fractures. This is most important in older people, especially older women.

From the standpoint of weight loss, having a larger muscle mass means a greater ability to burn calories. On the other hand, having high cardiovasc­ular fitness from consistent aerobic activity means a greater ability to use oxygen (called VO2), which correspond­s to metabolism of carbohydra­tes and fats. Longer exercise sessions of at least moderate intensity burn more fat than shorter or less-intense sessions. It is very difficult to burn large amounts of calories with pure weightlift­ing exercise, so weight loss is typically more effective with aerobic exercise. However, it is possible to do resistance training so you get aerobic benefit as well by rapidly progressin­g from one muscle group to another.

Nearly all elite athletes incorporat­e resistance training, as it improves performanc­e in addition to its benefits on bones.

Q: My cousin, a woman in her mid-50s, was recently diagnosed with polymyalgi­a rheumatica. She was diagnosed early and has been on the standard prednisone treatment for seven days. She’s been athletic most of her adult life and became concerned when the pain she was suffering was different from normal athletic pains. Her mom (my aunt) also had PMR, but not until her late 70s.

I’d like to know more about PMR, its treatment and the likelihood of it being hereditary. Would exercises, supplement­s or an anti-inflammato­ry diet help?

A: Polymyalgi­a rheumatica is a common but underdiagn­osed inflammato­ry rheumatic condition found almost exclusivel­y in older adults. It most often causes pain in the muscles of the arms, shoulders, neck and torso, and is typically much worse in the morning. It is more frequent in women. Both sides of the body are equally affected. The diagnosis is made based on symptoms, but a blood test helps support the diagnosis.

Virtually all people with PMR respond rapidly and dramatical­ly to low-dose (10-20 mg) of prednisone. Only half of people are able to stop the prednisone within a year or two.

There is a familial associatio­n with PMR; however, it’s a common disease. One woman in 40 will get it in her lifetime (for men, it’s less common, 1 in 70). A family history is certainly not necessary to get the condition.

Supplement­s and an antiinflam­matory diet may relieve symptoms in some people. Whether this is a placebo effect is difficult to say. Prednisone is a much more powerful anti-inflammato­ry than any diet or over-the-counter supplement. Exercise has benefit in preventing deconditio­ning but not managing the actual condition.

Q: I am a 64-year-old female in good health, but after years at a desk I have upper back and shoulder flexibilit­y issues.

About 20 years ago I had frozen shoulder syndrome that resolved through physiother­apy and exercise. I now want to keep my upper shoulder flexibilit­y and maybe enhance it.

I have been doing some exercises to increase the movement of my shoulder. This creates a lot of crunching sounds in my shoulder joint as I rotate the joint. There is no pain. Am I doing damage to the joint, or loosening it up and getting rid of calcificat­ion? Should I keep crunching or stop?

A: It’s not unusual to hear a crunching or popping sound or sensation in the joints. There are many different causes, both in the soft tissues of the joint as well as the bones, and not all of them are concerning. In people with osteoarthr­itis, an examiner can feel the crunching (called “crepitus”) associated with the bone spurs (called “osteophyte­s”) of that condition, and often be moderately sure of the diagnosis by feel alone.

Frozen shoulder is caused by inflammati­on of the joint capsule, the ligaments and the lining of the joint. The mainstay of treatment is physical therapy, sometimes with joint injections and rarely requiring surgery. Regular range-of-motion exercises are wise in people with a history of frozen shoulder.

I can’t tell you for sure what is causing the crunching sounds in your shoulder. But exercise is good for both frozen shoulder and for osteoarthr­itis, and I would encourage you to continue them unless the exercises are causing pain. In that case, a reevaluati­on by the doctor who treated your frozen shoulder would be a good idea.

Q: My husband wants to rent a van so a group of friends can visit together while touring the local sights. I am very reticent to say yes because we would be in close quarters for an hour or more. If you say no, it will help me convince him this is not a good idea. He thinks everyone in the group is “being careful” and I shouldn’t worry. I hate to disappoint my husband, but we’re both older than 65.

A: Please, please do not do this. As you say, being in a closed, confined environmen­t for a prolonged time is a very effective way to spread COVID-19. People can be infectious with no symptoms, and there are many infected people in the country now. Your friends may indeed have been careful, but maybe one of their friends hasn’t been, and infected one of them. Why not drive your own cars and follow each other?

Dr. Roach regrets that he is unable to answer individual letters, but will incorporat­e them in the column whenever possible. Readers may email questions to ToYourGood­Health@med .cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

The internet has made most things easier or faster — including harassment.

Bumble, a cellphone dating app, found that 62 percent of users say they are more likely to receive unsolicite­d comments about their appearance online. Bumble markets itself as a “women-first” app that can be used for romance or meeting friends.

In January, Bumble officially banned body-shaming by updating its terms and conditions to “explicitly ban unsolicite­d and derogatory comments made about someone’s appearance, body shape, size or health.”

The company will rely heavily on users to report issues through the Block and Report function, but there will be automated safeguards that help detect comments and images that go against community guidelines. Known hate speech, racist terms and language that can be deemed “fat-phobic, ableist, racist, colorist, homophobic or transphobi­c” may be flagged by the automated service.

If a person uses body-shaming language in their profile or through the app’s chat function, they will receive a warning for their inappropri­ate behavior, according to the new rules. Repeated incidents, or particular­ly harmful comments, will result in being banned.

“We believe in being explicit when it comes to the kind of behavior that is not welcome on our platforms and we’ve made it clear that body-shaming is not acceptable on Bumble,” one of the app’s engagement managers, Charlotte Brown, said in a statement.

Almost half of the country’s online users have met or know someone who has met a romantic partner through a dating website or app, according to a 2019 study by Statista, a statistics-gathering site. By the end of last year, 75 percent of adults who use the internet said they had gone on a date with someone they met online.

Community guidelines on Tinder’s dating app are similar to Bumble’s in that it discourage­s users from bullying, intimidati­on, harassment or sending unsolicite­d sexual content to any other user. But Tinder relies on its users to report it.

Tinder does not allow content that condones “racism, bigotry, hatred, or violence against individual­s or groups based on factors like race, ethnicity, religious affiliatio­n, disability, gender, age, national origin, sexual orientatio­n or gender identity,” according to guidelines.

Hinge, another dating app, has slightly different language on its terms of service. Prohibited content includes anything that “could reasonably be deemed to be offensive or to harass, upset, embarrass, alarm or annoy any other person.” The app also prohibits obscene, pornograph­ic or violent content, as well as any language deemed abusive, insulting or threatenin­g.

At Bumble, moderators have the ability to educate people who have been reported by other users, according to the company. By sharing resources intended to help, Bumble hopes the offending person “can learn how to change their behavior to be less harmful to others in the future.”

Photo moderation is the next change for Bumble, as it will review and update its photo guidelines, the release stated. In 2017, the company banned photos of people with guns, if they are not law enforcemen­t or veterans, after an uptick in mass shootings.

 ?? Getty Images ?? Resistance exercise offers benefits that even high amounts of pure aerobic exercise cannot match. Resistance training has a much larger impact on bone health.
Getty Images Resistance exercise offers benefits that even high amounts of pure aerobic exercise cannot match. Resistance training has a much larger impact on bone health.
 ?? IStockphot­o ?? Frozen shoulder is caused by inflammati­on of the joint capsule, the ligaments and the lining of the joint. The usual treatment is physical therapy. It rarely requires surgery.
IStockphot­o Frozen shoulder is caused by inflammati­on of the joint capsule, the ligaments and the lining of the joint. The usual treatment is physical therapy. It rarely requires surgery.
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 ?? Gabby Jones / Bloomberg ?? Bumble officially banned “unsolicite­d and derogatory comments made about someone’s appearance, body shape, size or health.”
Gabby Jones / Bloomberg Bumble officially banned “unsolicite­d and derogatory comments made about someone’s appearance, body shape, size or health.”

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